Rosacea

by Jennifer Abney

Published: Thu, August 07, 2008 - 4:00 am CST Last Updated: Thu, August 07, 2008 - 4:16 am CST

Rosacea is a condition characterized by a tendency toward skin blushing. Although it most commonly is seen on the face, the symptoms can also occur on the scalp, neck, chest, ears and back. Other signs include a burning sensation, swelling, development of small red lines under the skin, pimples and thickening of the skin. The nose may become red, swollen and bumpy and may appear enlarged. Some patients have eye involvement, causing the eyes to feel irritated, watery and bloodshot.

The American Academy of Dermatology estimates about 14 million Americans have rosacea. The condition is most common in women, adults between 30 and 50 and those with fair skin, blue eyes and blonde hair.

The exact cause of rosacea isn’t known. However, some factors can trigger the symptoms. Some of the most common triggers include: heat, sunlight, wind, extreme cold, heavy exercise, drinking alcohol, consuming hot or spicy foods or drinks, menopause, emotional stress and long-term use of topical steroids on the face.

Finding a Clue
Researchers at the University of California, San Diego have been studying the role of a family of molecules, known as antimicrobial peptides, in development of rosacea. These peptides normally protect the skin from infection, but seemed to also be associated with rosacea symptoms. One particular antimicrobial peptide stood out – cathelicidin.

To explore the possible link, the investigators took skin samples and biopsies from rosacea patients. They found patients with rosacea had significantly higher levels of cathelicidin. In addition, the cathelicidin found in rosacea patients was a different form than that found in people without rosacea.

Researchers also found patients had higher levels of an enzyme called stratum corneum tryptic enzyme (SCTE). This enzyme appears to convert the cathelicidin into another peptide that triggers rosacea symptoms.

Dermatologist Richard Gallo, M.D., Ph.D., says the findings explain why tetracycline, a type of antibiotic, reduces symptoms in some patients with rosacea. Tetracycline inhibits the enzymes that convert the cathelicidin into an inflammatory peptide. But it doesn’t work for everyone. In the future, Gallo would like to see the development of medications that specifically target the enzyme or the proteins and prevent the onset of rosacea symptoms.

For general information on rosacea:
American Academy of Dermatology, http://www.skincarephysicians.com
National Institute of Arthritis and Musculoskeletal and Skin Diseases, http://www.niams.nih.gov
National Rosacea Society, http://www.rosacea.org

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